Infection is a leading cause of death for multiple myeloma patients and protection against infection is key, especially during stem cell transplant. At certain points during stem cell transplant, your immune system is at an all time low until your immune system “reboots” when stem cells are given back. Learn from transplant expert Jennifer Saullo, MD, PharmD of Duke University Medical Center as she shares ways to protect myeloma patients from infections before, during and after stem cell transplant.  Dr. Saullo is Assistant Professor of the Division of Infectious Diseases at Duke University. She serves on editorial boards of the Open Forum Infectious Diseases and reviews journals including Medical Mycology, BMJ Case Reports, and Clinical Infectious Diseases. She received the Meritorious Service Award at Duke, and several teaching and resident awards from Columbia University.  Dr. Saullo performs both basic and applied research on topics such as mass spectrometry, B cell immune deficiencies after transplant, transplant infectious disease management and vaccination for transplant recipients.  Thanks to our episode sponsor, GlaxoSmithKlein

What innovation is coming in 2020 in myeloma research? Dr. Robert Orlowski of the the MD Anderson Cancer Center shares the insights learned from the recent American Society of Hematology meeting and highlights leading edge research expected in 2020. There is a stunning amount of development happening in myeloma - immunotherapies like CAR T, bi-specific antibodies, tri-specific antibodies and antibody drug conjugates, new findings in precursor conditions like MGUS and smoldering myeloma, new targeted therapies for relapsed and refractory myeloma and a host of different treatment combinations. Dr. Orlowski will give a broad and comprehensive review of what we can expect to see in 2020. Join us for this favorite annual show.   Dr. Orlowski is Chairman, Ad Interim, Director of Myeloma, and Professor of Medicine in the Departments of Lymphoma/Myeloma and Experimental Therapeutics, Division of Cancer Medicine at MD Anderson Cancer Center. Dr. Orlowski serves as Chair of the Southwest Oncology Group (SWOG) and is a member of the NCI Steering Committee, the Multiple Myeloma Tissue Bank Steering Committee, the Computerized Provider Order Entry Steering Committee, BMT Committee, and American Society for Biochemistry and Molecular Biology. Dr. Orlowski is on the Editorial Board of Hematology and the Journal of Clinical Oncology. Dr. Orlowski has received many awards over a number of years including the Leukemia & Lymphoma Society Scholar in Clinical Research, the Leukemia & Lymphoma Society’s Man of the Year Award, Emil Frei III Award for Excellence in Translational Research from MD Anderson and has received a SPORE grant from the NIH. Find news and information from his daily newspaper, Myeloma Daily or find him on Twitter at @myeloma_doc. Thank you to our episode sponsor, GSK.

Many myeloma patients are elderly, with the average age of diagnosis being 68. If individuals are fit and active, they can typically receive the "standard of care" drugs such as stem cell transplant or triplet drug combinations. But many individuals may be frail or have other health conditions that would required doctors to adjust treatment accordingly. Dr. Tanya Wildes, MD of the Washington University Siteman Cancer Institute shares how treatment can be modified for more frail patients and how therapy should be personalized for us all.  Thanks to our episode sponsor, Takeda Oncology.

How much does a cancer cell weigh? And why does it matter? As cancer cells die, they change their weight in a matter of hours. A new device called the Suspended Microchannel Resonator (SMR) is a new technology that can measure a small change in the weight of a single cancer cell. The SMR machine can detect this change and tell whether a cancer cell has died of "natural causes" or if it was killed by a cancer drug. This allows rapid assessment of whether an individual patient is responding to a cancer treatment or not. This wraps together everything about a cancer patient (such as their myeloma genetics, environmental and other biological factors) and analyzes the response to treatment, making it truly personalized medicine.  A company called Travera is now working to commercialize this technology developed in the Manalis Laboratory in the Koch Institute for Integrative Cancer Research at MIT. It was recently tested in multiple myeloma in a small study at Dana Farber. Learn more about this fascinating technology that may create the first universal biomarker for cancer in this interview with Traver's CEO, Clifford Reid, PhD.  Thank you to our episode sponsor, GSK.

Cellectar Biosciences is working on testing a radiosensitive therapy in blood cancers including multiple myeloma. Their product, CLR 131, targets the myeloma tumors by delivering a cytotoxic radioisotope, iodine-131 directly to the tumor cells. Phase I study results showed an overall mean survival rate of 26.2 months for relapsed/refractory myeloma patients (who had received on average 5.8 prior lines of therapy). The drug was given as a one or two-dose treatment as a single agent, given during a 30-minute infusion. These results are promising when compared to recently FDA-approved myeloma treatments.  A Phase II study is now open using CLR 131 and dexamethasone for blood cancer patients including: multiple myeloma (MM), indolent chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), lymphoplasmacytic lymphoma (LPL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), and diffuse large B-cell lymphoma (DLBCL) who have been previously treated with standard therapy for their underlying malignancy. Learn more in this show with Dr. Natalie Callander of the University of Wisconsin School of Medicine.  Thanks to our episode sponsor, GSK.

Irene Ghobrial, MD of the Dana Farber Cancer Institute and Ivan Borrello, MD of Johns Hopkins are leading the largest study on precursor myeloma conditions that will include 50,000 patients and family members. The goal of the study is to detect myeloma early and see why and how patients who have MGUS and smoldering myeloma progress to active myeloma. The study is also seeking to understand the genetic, molecular and immune factors that lead to disease progression with the hope that this knowledge could stop disease progression and improve survival with effective strategies.   If you are African American or family member of a myeloma patient between the ages of 40-75, it's time to join this important study, which requires no travel. These two groups are involved in the study because they are more likely to develop into active myeloma. The Dream Team will study this group in an effort to define biological characteristics that will help to identify which patients will benefit from particular therapies. These biological characteristics include inherited mutations, acquired mutations, and immune factors. The Dream Team will also identify lifestyle and demographic factors that contribute to disease progression, such as obesity and race. The PROMISE study is funded by Stand Up To Cancer, who has provided a $10 million award to the Myeloma Stand Up To Cancer Dream Team focused on revolutionizing the treatment of multiple myeloma through detection of early conditions before they turn into full-blown disease.  Learn more about how you and your family members can join! Thanks to our episode sponsor, Karyopharm Therapeutics

Why is a myeloma specialist so important? What does it take to create a new myeloma research center from scratch? William Matsui, MD recently left Johns Hopkins to do just that. Dr. Matsui is the Deputy Director of the new University of Texas Dell Medical School's LIVESTRONG Cancer Institutes myeloma program. Learn what it takes to develop a new myeloma research center and lab and how it helps develop new strategies that could potentially extend lives. Dr. Matsui's unique focus on precursor stem cells, allo transplant approaches and immunotherapy in myeloma care will also be discussed.  William Matsui, MD is Deputy Director of the LIVESTRONG Cancer Institutes at Dell Medical School. He specializes in caring for patients with cancers that involve the blood and bone marrow as well as bone marrow transplantation. Matsui came to Austin from the Johns Hopkins University School of Medicine, where he was a professor of oncology and served as the director of the Multiple Myeloma Program and the co-director of the Division of Hematologic Malignancies. Matsui received his undergraduate degree in biochemistry from Harvard College and his medical degree from the University of California at San Francisco. He completed his residency training in internal medicine at the University of Washington in Seattle and his clinical training in medical oncology at Johns Hopkins. Thanks to our episode sponsor, Celgene.

A new treatment called Selinexor was recently approved for highly relapsed multiple myeloma patients. Learn how experts like Dr. Paul Richardson of the Dana Farber Cancer Institute are using this new drug in their myeloma practice. Dr. Richardson will share how the drug works, when and how it should be used, potential side effects to watch out for and manage and why the new option is adding to patients' treatment choices.  Paul Richardson, MD is RJ Corman Professor of Medicine at Harvard Medical School and Attending Physician in the Division of Heamatologic Oncology in the Multiple Myeloma and Bone Marrow Transplant Service at the Dana Farber Cancer Institute. Dr. Richardson is the Clinical Program Leader and Director of Clinical Research for The Jerome Lipper Multiple Myeloma Center at the Dana-Farber Cancer Institute. Thank you to our episode sponsor, GlaxoSmithKlein.

Immunotherapy is a major class of therapy that continues to expand in the myeloma clinic. Dr. Alexander Leshokin of Memorial Sloan Kettering Cancer Center explains the various types of immunotherapies: transplant, monoclonal antibodies, bi-specific antibodies, antibody drug conjugates, cellular therapies like CAR T, vaccines and where each type of treatment is at in the various stages of development.  Dr, Alexander Lesokhin is Assistant Attending Physician at Memorial Hospital for Cancer and Allied Diseases and Assistant Member of Memorial Sloan Kettering Cancer Center. He is an active member of ASCO and ASH and has oversight of fellows and residents in the transplant, lymphoma and myeloma units. Dr. Lesokhin performs significant immunotherapy research and is engaged in studies to perform work in the lab that will bridge to the clinic as to why cancer cells can evade the bone marrow derived tumor-infiltrating cells. He is also performing research on checkpoint inhibitors and why T cells get exhausted, particularly following stem cell transplant.  Thanks to our episode sponsor, Celgene.

STEP therapy is an approach in managed medical care to minimize costs of prescription drugs. The program allows patients to begin therapy with the most cost-effective drugs and work their way up to more costly therapies only if necessary. It is also called "step protocol" or "fail first" and is a type of prior authorization requirement. Upward trends for prescription medications in the United States has led to an increased pressure on health care providers to keep medication costs down while maintaining drug availability. The cost controlling measures could impact cancer therapies for all patients, but it may be a particular challenge for myeloma patients who tend to used combination therapies in a serial fashion. Learn more about this and other issues about cost in myeloma care with Dr. Rafael Fonseca, Chair the Mayo Clinic Scottsdale program.  Dr. Rafael Fonseca is the Chair of the Department of Internal Medicine and Professor of Medicine at the Mayo Clinic in Scottsdale. He is also Getz Family Professor of Cancer in Mayo Clinic College of Medicine and Science in the Department of Education Administration. He is a Distinguished Mayo Investigator since 2010 and is also a Consultant in the Divisions of Hematology/Oncology and Basic Sciences Research Laboratories at the Mayo Clinic. Dr. Fonseca is an Editorial Board Member for the publication Genes, Chromosomes and Cancer. Dr. Fonseca is also on the Mayo Clinic Arizona Executive Operations Team  and Editorial Board.